Abstract
BackgroundThis study aimed to compare the arthroscopic internal drainage of popliteal cysts alone or in combination with cyst wall resection in terms of clinical outcomes.MethodsForty-two consecutive patients with symptomatic popliteal cysts received arthroscopic treatment. Specifically, 20 of them received arthroscopic internal drainage (AI group) alone and 22 received arthroscopic internal drainage combined with cyst wall resection (AICR group) through double posteromedial portals. Magnetic resonance imaging (MRI) was performed to identify recurrence of popliteal cysts. The Lysholm score and Rauschning-Lindgren grade were used to assess the clinical outcomes. The median of the follow-up period was 24 months (12–48 months).ResultsThe two groups (AI group and AICR group) were similar in age, gender, cyst diameter, associated joint disorder, preoperative Lysholm score, preoperative Rauschning-Lindgren grade and follow-up period (P > 0.05). Relative to the AI group, the AICR group had a significantly prolonged operation time (P < 0.05) and a higher incidence of complications (P < 0.05). In both groups, the Rauschning-Lindgren grade at the last follow-up significantly differed from the preoperative grade (P < 0.05) and the Lysholm knee score remarkably increased compared to the preoperative score (P < 0.05); however, there were no differences between the two groups at the last follow-up (P > 0.05). According to the MRI results, the cyst disappeared in 11 (55%), shrank in size in 6 (30%) and existed in 3 (15%) patients in the AI group, and was absent in 18 (81.8%) and shrank in size in 4 (18.2%) patients in the AICR group, suggesting a significant difference between the two (P < 0.05).ConclusionAdditional resection of cyst wall can result in a lower recurrence rate of cysts but extend the operation time and increase the incidence of perioperative complications compared with arthroscopic internal drainage of popliteal cysts alone.
Highlights
This study aimed to compare the arthroscopic internal drainage of popliteal cysts alone or in combination with cyst wall resection in terms of clinical outcomes
Popliteal cysts, or Baker’s cysts [1], are typically characterized by enlargement of the gastrocnemius-semimembranosus bursa, which communicates with the knee often through a valve-like structure associated with knee osteoarthritis or meniscus tear [2]
In the Arthroscopic Internal Drainage (AI) group, the distributions of articular pathologies associated with Baker cysts were as follows: synovitis in 5 knees (25%), medial meniscal tear in 4 knees (20%), lateral meniscal tear in 2 knees (10%), chondral degeneration in 12 knees (60%) and loose body in one knee (5%)
Summary
This study aimed to compare the arthroscopic internal drainage of popliteal cysts alone or in combination with cyst wall resection in terms of clinical outcomes. The presence of a oneway valve leads to unidirectional flow of fluid from the articular cavity to the bursa. This is a fundamental factor that is involved in the formation and persistence of cysts [3]. Several studies have reported excellent outcomes of arthroscopic internal drainage of popliteal cysts without cystectomy by broadening the opening of cysts to eliminate the unidirectional flow [7,8,9,10]. Studies that directly compared arthroscopic valve debridement with and without cystectomy were rarely reported for the time being
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
